Biliary atresia: the Brazilian experience

Carvalho, Elisa de; Santos, Jorge Luiz dos; Silveira, Themis Reverbel da; Kieling, Carlos Oscar; Silva, Luciana Rodrígues; Porta, Gilda; Miura, Irene Kazue; Tommaso, Adriana María Alves De; Brandâo, María Àngela Bellomo; Ferreira, Alexandre Rodrígues; Macedo, José Roberto de Deus; Neto, José Tenório de Almeida

doi:10.4067/s0370-41062012000500013

Cited by 4 publications

(4 citation statements)

References 34 publications

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“…Since our publication of this observation, a few more studies have reported similar findings: that a slight delay in the Kasai operation would not significantly affect the outcome, including a recent systematic review published by a group of Japanese surgeons 4. That group analysed the relationship between the timing of surgery and outcomes based on several international publications 13. The authors concluded that a straightforward relationship could not be established, possibly due to the difference in the aetiology of BA.…”

Section: Discussionmentioning

confidence: 60%

Standard management protocol to improve the short‐term outcome of biliary atresia

Chung

Wong

Tam

2020

J Paediatrics Child Health

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Aim This study compared the outcomes of patients with biliary atresia (BA) treated according to a standardised protocol with historical patients. Methods This is a single‐centred retrospective study of BA patients treated from 1980 to 2016. A standardised treatment protocol was established since 2008 regarding peri‐operative management. The outcomes being compared between the two groups (Groups I and II = before and after 2008, respectively) were jaundice clearance (JC), incidence of recurrent cholangitis, hospital admission and native liver survival (NLS). Results A total of 128 patients were included (Group I = 100, Group II = 28). The overall median follow‐up period was 15.3 years (I vs. II = 20.6 years vs. 5.1 years, respectively). There was no significant difference in the JC at the sixth month between the two groups (I vs. II = 60.0 vs. 82.1%, respectively, P = 0.07). The incidence of recurrent cholangitis was similar between the two groups (I vs. II = 39 vs. 35.7%, respectively, P = 0.45), but the median hospital admission episode per patient was non‐significantly higher in Group I (I vs. II = 4.2 vs. 2.7, respectively, P = 0.08). There was an improvement in the 1‐year NLS rate in Group II (I vs. II = 69.0 vs. 85.7%, respectively, P = 0.05). Conclusions The introduction of a standardised management protocol has improved the short‐term outcome of BA patients, with a better 1‐year NLS observed.

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Section: Discussionmentioning

confidence: 60%

Standard management protocol to improve the short‐term outcome of biliary atresia

Chung

Wong

Tam

2020

J Paediatrics Child Health

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“…In several countries with a high incidence of BA, such as Taiwan and Japan [14][15][16][17][18][19] , a stool color card (SCC) for the screening of patients with suspicion of BA was created since the 90s to decrease the detection age of children with BA. The original card was described by Matsui and Dodoriki 20 and initially included eight colors marked from 1 to 4 as an abnormal acholic stool.…”

Section: Introductionmentioning

confidence: 99%

Stool color card use for early detection of biliary atresia

Reyes-Cerecedo¹,

Flores-Calderón²,

Villasís‐Keever³

et al. 2023

BMHIME

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Background: Biliary atresia (BA) is a condition that obstructs biliary flow. If it is not corrected surgically, it can cause cirrhosis and death before 2 years of age. In Mexico, since 2013, the stool color card (SCC) was incorporated into the National Health Card (NHC) for the screening of BA. This study aimed to evaluate the impact of SCC for the detection of BA before and after its incorporation to the NHC. Methods: This is an ambispective, analytical observational study. We included patients with BA treated in two pediatric specialized hospitals. We compared the age of reference, diagnosis, and surgery before and after incorporation of the SCC. Furthermore, a questionnaire was made for the parents to know their perception about the SCC. Results: In 59 children, there was no difference among the time of diagnosis (75 vs. 70 days of life) or at the time of the surgery (84 vs. 90 days of life) between the pre-and post-implementation of the SCC on the NHC. The questionnaire showed that 10 (30%) of the parents received information about the use of the SCC and only 13 (38%) identified the abnormal stool. Conclusions: This study did not show changes in time for the timely detection of BA using SCC. Therefore, it is necessary to reinforce the program in the three levels of care in our country.

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“…1 , 2 The most common cause in infants in Brazil is biliary atresia, characterized by partial and/or complete obstruction of the extrahepatic bile ducts and the main indication for liver transplantation (LT), a treatment increasingly adopted in pediatric patients in both developed and developing countries. 2 , 3 , 4 , 5 , 6 , 7 …”

Section: Introductionmentioning

confidence: 99%

Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

Mazzoni

Lessa

Zamberlan

2022

Rev. paul. pediatr.

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Objective: To describe the metabolic and nutritional repercussions of chronic liver disease (CLD), proposing strategies that optimize nutritional therapy in the pre- and post-liver transplantation (LT) period, in order to promote favorable clinical outcomes and adequate growth and development, respectively. Data sources: Bibliographic search in the PubMed, Lilacs and SciELO databases of the last 12 years, in English and Portuguese; target population: children from early childhood to adolescence; keywords in Portuguese and their correlates in English: “Liver Transplant,” “Biliary Atresia,” “Nutrition Therapy,” “Nutritional Status,” and “Child”; in addition to Boolean logics “and” and “or,” and the manual search of articles. Data synthesis: Malnutrition in children with CLD is a very common condition and an important risk factor for morbidity and mortality. There is an increase in energy and protein demand, as well as difficulties in the absorption of carbohydrates, lipids and micronutrients such as fat-soluble vitamins and some minerals. An increase in the supply of energy, carbohydrates and proteins and micronutrients, especially fat-soluble vitamins, iron, zinc and calcium, is suggested, except in cases of hepatic encephalopathy (this restriction is indicated for a short period). Conclusions: Based on metabolic changes and anthropometric and body composition monitoring, a treatment plan should be developed, following the nutritional recommendations available, in order to minimize the negative impact of malnutrition on clinical outcomes during and after LT.

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Biliary atresia: the Brazilian experience

Cited by 4 publications

References 34 publications

Standard management protocol to improve the short‐term outcome of biliary atresia

Standard management protocol to improve the short‐term outcome of biliary atresia

Stool color card use for early detection of biliary atresia

Metabolic and Nutritional Repercussions of Liver Disease on Children: How to Minimize Them?

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